Lateral soft tissue neck X-ray positioning
One of the routine soft tissue neck views. The patient stands side-on, the beam passes from side to side, straight on to the receptor, and the centring point is the thyroid cartilage.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
X-ray positioning/Soft tissue neck
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Lateral, erect. Stand the patient lateral to the bucky, shoulders down, chin slightly raised.
Centring & collimation
Central ray
lateralCentre: the thyroid cartilage.
Beam: lateral, perpendicular to the receptor.
Collimate: nasopharynx to the thoracic inlet
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 150 cm | |
| Receptor | 24 × 30 cm | portrait |
| Placement | Erect (wall) bucky | Grid in |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: R or L marker on the side nearest the detector
- Breathing: Breathe in and hold.
Exposure by patient size
Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.
| Patient size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 70 | 6.3 | 2.5 |
| S | 70 | 10 | 4 |
| M | 70 | 12.5 | 5 |
| L | 70 | 20 | 8 |
These start from a classic film-screen chart (70 kV, 10 mAs at 140 cm) and are adjusted for a digital detector at 150 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.
Image quality checklist
- Prevertebral soft tissue and airway shown.
- Shoulders below C7.
- The anatomical side marker is visible, correct and clear of the anatomy.
- Collimation borders are visible on all sides, no wider than the area requested.
Faults & how to fix them
| Fault | Cause | Fix |
|---|---|---|
| Shoulders over the lower neck | Shoulders not depressed | Pull the shoulders down. |
Common questions
- Where do you centre for a neck soft tissue lateral X-ray?
- The centring point is the thyroid cartilage.
- What distance and beam angle does a neck soft tissue lateral need?
- 150 cm from the tube to the receptor. The beam passes from side to side, straight on to the receptor.
- What size receptor, and do you need a grid?
- Use a 24 × 30 cm receptor, portrait, in the wall bucky. A grid is needed.
- What should the patient do with their breathing?
- Ask them to breathe in and hold it while you expose.
- What goes wrong most often on a neck soft tissue lateral?
- Shoulders over the lower neck. Usual cause: shoulders not depressed. The fix: pull the shoulders down.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a neck soft tissue lateral in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.